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Arizona rates for HCPCS 95972

Electronic analysis of implanted neurostimulator pulse generator/transmitter (eg, contact group[s], interleaving, amplitude, pulse width, frequency [Hz], on/off cycling, burst, magnet mode, dose lockout, patient selectable parameters, responsive neurostimulation, detection algorithms, closed loop parameters, and passive parameters) by physician or other qualified health care professional; with complex spinal cord or peripheral nerve (eg, sacral nerve) neurostimulator pulse generator/transmitter programming by physician or other qualified health care professional

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$36.59 / $58.57 / $112.21
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$77.62 / $306.61 / $507.86
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.35 / $40.31 / $56.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.30 / $64.30 / $399.05
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.98 / $81.61 / $148.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$37.59 / $57.01 / $122.99
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.46 / $103.97 / $693.25
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.84 / $92.40 / $150.62